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1114920360
KULSOOM SHAH
STONY BROOK, NY
NPI
1114920360
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
207Q00000X Family Medicine
(Licence: NY 224192-1)
Enumeration Date
2005-05-23
Last Update Date
2007-07-08
Business Address
Dr. KULSOOM SHAH M.D
1 STADIUM RD,STUDENT HEALTH CENTER,STONYBROOK UNIV
STONY BROOK, NY 11794-0001
Phone number: 631-632-6740
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Mailing Address
Dr. KULSOOM SHAH M.D
52 AVALON CIR
SMITHTOWN, NY 11787-3855
Phone number: 631-863-1634
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